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Yesterday’s post, which highlighted an article from the October 2014 issue of Tatler, reprised a comment from a urologist who said that ketamine ‘works like paint stripper’.

Widespread but not universal

Ketamine became popular in the UK after the Millennium and went nationwide by 2005. With so many more users — most of whom start in their late teens — urologists are seeing some disturbing cases of bladder damage. This started becoming more common as early as 2007.

Erowid tells us that, in that year, ketamine users began seeking medical help for such complaints. Ketamine is popular not only in Western countries but also in Asia. Erowid‘s research on ketamine tells us that a Hong Kong study revealed that the median age of the patient was 22 years. The site emphasises that between 3.6% and 12% might experience lower urinary tract symptoms (LUTS). Therefore, whilst not everyone will have these problems, no one is certain as to who will have them and when.

Erowid adds that it is unclear why such cases are increasing in number. It is not just the ketamine user who buys locally or on the internet. People whose doctors prescribe a short dose of ketamine for medical reasons — pain relief, depression — have also experienced bladder difficulty. These patients normally recover after they stop taking ketamine.

Case study

in 2011, BJU International, a journal for urologists, featured an article on ketamine’s effect on the bladder. It recaps a 20-year old man’s case and treatment. In his case, kidney and digestive functions and tests were normal. The site also has photos from the scans — instructive and good for adolescents to see.

Excerpts follow, emphases mine:

Cystoscopy under general anaesthesia revealed a small capacity bladder (less than 100mls). The bladder mucosa was friable and appeared to be “tearing” with distension. Due to persistent bleeding and mucosal tearing on distension the procedure had to be abandoned and a bladder biopsy therefore was not performed. The patient was then catheterised and treated conservatively.

Based on the cystoscopic findings a bladder perforation was suspected and a post operative CT scan was performed to confirm the diagnosis. The CT scan showed free fluid and gas in the pelvis. There were locules of gas and extensive haematoma within the bladder suggestive of an extraperitoneal bladder perforation (Figures 1 and 2).

A more detailed history at this point revealed that he has been abusing ketamine intermittently as a recreational party drug (not daily usage). His weekly consumption of ketamine was variable and the patient was unable to quantify the amount used. His haematuria settled with conservative management. The catheter was left in situ for four weeks. At the time of discharge from hospital he was advised to stop ketamine abuse. After cessation of ketamine abuse and catheter removal he reported remarkable improvement in his symptoms. There was no further recurrence of haematuria. One year after discontinuing ketamine abuse he has ongoing frequency which he does not find troublesome.

Once his symptoms resolved a repeat cystoscopy and bladder biopsy under general anaesthesia and a frequency volume chart to assess functional bladder capacity were recommended. However the patient repeatedly failed to respond to our requests to attend urology department for further evaluation. He was subsequently discharged from follow up.

Hospital study of patients prescribed ketamine

A thesis paper by Khurram Shazhad attempts to make sense of ketamine’s effect on the bladder. He was part of a team that conducted a study at James Cook University Hospital in Middlesborough. The study examined tissue from patients who had been prescribed ketamine (‘analgesic ketamine’).

Shazhad concludes (p. 85) that the casual user’s bladder problems may heal by themselves once ketamine use stops.

Patients taking analgesic ketamine may experience problems within weeks or months. One patient who had been prescribed ketamine over a period of three years required surgical intervention. Shazhad’s paper also posits that increased concentration and daily use of ketamine may exacerbate bladder problems.

Symptoms to watch for

A 2013 article from The Mirror reported findings from prominent urologists and other physicians who hoped to persuade the British government to reclassify ketamine from a class C to a class B drug. Home Secretary Theresa May did so in 2014.

The article reveals what the symptoms are and how they are treated:

ACMD member Dr Paul Dargan, consultant physician and clinical toxicologist at Guy’s and St Thomas’ NHS Foundation Trust, is preparing a report for the Home Secretary to be released shortly.

He said: “The main area where there’s significant evidence is around bladder toxicity. There is clear evidence of significant bladder toxicity in those who are regular high dose, dependent ketamine users with potential severe and disabling symptoms.

“Significant pain is often a feature which may lead users to take higher doses of ketamine to treat their pain, and therefore a vicious cycle is developing of pain leading to more ketamine use, leading to more bladder damage, passing blood in the urine, having to go to the toilet frequently and having incontinence.”

He added: “Those who have severe bladder symptoms may require significant and life-changing surgery that can include removing the bladder and ending up with a bag to pass urine into, or diversion of the urine into the bowel. Clearly that’s a significant thing for a user to have to end up with.”

Dr Dargan said users across the age-spectrum are having bladders removed, including people in their “20s, 30s, 40s and 50s”.

A young woman described her urinary tract damage after several years taking ketamine (see last comment). She passed jelly-like tissue and blood clots. Her doctor told her that ketamine was altering the inner tissue of the bladder; the jelly-like substance was the affected tissue. The woman was urinating every 10 minutes. Now, having stopped taking the drug, her bladder has healed. She can hold her urine for five or six hours.

A young man writing anonymously for The Guardian tells us:

After about two years of using ketamine, I was spending more and more time in the toilet, and urinating was beginning to hurt.

I developed a stoop because my penis was always burning. One day, on a train, I had my first cramp attack; I thought my lung had collapsed. I went to a doctor, who told me to stop taking K or I would die, but then an older user told me not to worry, it was “just K cramps“. He said that they wouldn’t kill me, but I might wish that they would. Apparently they could last for days.

I still didn’t stop. The cramps got worse, the blood and mucus began to appear frequently in my urine and I had to pee every 20 minutes. I lied more than I told the truth, particularly to my girlfriend, and I hated myself. I couldn’t stand to be around myself and wanted to cause myself harm. K worked on both fronts.

Graphic photos of ketamine-related bladder treatment

In 2013, the BBC aired an anti-drug programme called Old Before My Time.

One of the addicts featured, Chris from Hampshire, had to have bladder surgery and a catheter put in place. He was only 23 by the time this happened. He began smoking dope when he was 12 and moved to ketamine in his mid-teens.

By the time he was 17, he had problems urinating. He ended up with the bladder of an 80-year old and required drastic surgery.

Any youngster who thinks ketamine won’t harm them really needs to see the Daily Mail‘s pictures of what Chris looks like today and the ongoing treatment he needs to undertake.

The Mail describes — with the aid of documentary stills — what he has to do for the rest of his life:

Although he has a new bladder, he is by no means free of health problems.

Every two weeks he must insert a catheter – a thin, flexible tube – into his belly button and syringe out mucus sitting in his bladder.

Viewers see the stomach-turning moment where the mucus fills the syringe attached to the tube in his stomach – a far cry from the hard core raver he once was just a few years ago …

A normal bladder can hold up to 500ml – but Chris’ could hold just 5ml.

Normally, the bladder wall expands when filled with urine and contracts when emptied.

But extreme ketamine use can cause stiffness and scarring in the bladder walls which means it can only expand to a tenth of its normal size.

To avoid a lifetime of incontinence, Chris had two options. He could have a bag attached to his hip – or have his bladder removed totally and a new one made from his bowel – surgery typical in someone 60 or 70 years of age.

He went for the latter – but must now syringe mucus out of his bladder for every two weeks of his life.

His days of playing rugby are over and he is at risk of dangerous kidney infections.

His new bladder won’t forever, either – he will need it replacing again in 20-30 years.

It’s nothing short of tragic.

Memory loss

The Mail article also looked at Dave’s case, featured in the BBC documentary.

Extensive ketamine use has left Dave with a form of dementia more common to elderly people.

Ketamine blocks certain brain receptors.

Today, Dave has problems with memory recall: words beginning with ‘f’ and remembering the names of fruit, to name but two.

At the time the documentary aired, Dave wasn’t yet able to stop using ketamine, although he said he was only taking it once a month. Yet, tests show that he must stop completely for the sake of his cognitive abilities.

Conclusion – make sure young people understand the dangers

The aforementioned anonymous writer for The Guardian (who has now gone back to smoking pot, although he is working and recovered) says:

people should know what they are dealing with. By the time I did, it was too late. There is so much media coverage of illegal drugs, yet K is rarely mentioned, although it is everywhere and spreading fast. Most people who try it won’t develop any major problems, but a minority of users get very sick. A friend of mine lost so much control over his bladder that he had to have a catheter fitted when he was 21, and there are going to be a lot more cases like this. He didn’t know it was addictive either.

Ketamine is not a safe drug, by any means.

Until a few weeks ago, I was under the impression that ketamine was a lesser ‘party’ drug.

However, an article in the October 2014 issue of Tatler put paid to that notion.

Ketamine is far from harmless.

Some recreational users turn into addicts who end up losing their jobs and friends. An increasing number of habitual users have also permanently ruined their bladders, stomachs and muscles.

In 2014, the UK government reclassified ketamine to a class B controlled drug. Possession now carries the risk of a five-year prison term and unlimited fine.  (The government had declared ketamine illegal in 2006, declaring it a class C substance.)

The Tatler article explains more, both from a clinical and personal perspective. What follows is taken from ‘Ketamine: Only for Fools and Horses’ by Sophia Money-Coutts (pp. 111-116). I was shocked by what I read.

Background information

- Why ketamine? It’s cheap (£15-£20 per gram), relaxes the user from a cocaine or MDMA high, makes him giggly and is a hallucinogenic (pp. 111-112).

- Any legitimate uses? Ketamine was invented in 1962 in the United States for use as an anaesthetic for animals and humans. It is best known as a ‘horse tranquilliser’. It is still used clinically on humans. Vietnam War medics used it on injured troops; it is a powerful, fast-acting anaesthetic which can suppress pain without affecting vital functions (p. 112).

- How did it become recreational? After the Vietnam War ended, psychiatrists began examining the hallucinogenic side of ketamine. It became a party drug in the 1990s and went mainstream after the Millennium. Max Daly, author of Narcomania: How Britain Got Hooked on Drugs calls it ‘the modern LSD’ (p. 112).

- Early anecdote? In 1978, Sheraton Hotels heiress Marcia Moore published a book called Journeys into the Bright World in which she wrote that the world would be a ‘Garden of Eden’ if only government leaders and captains of industry took this ‘love medicine’. In 1979, she mysteriously disappeared from her California home. In 1981, her skeleton was found in a nearby forest. It is thought that Moore climbed a tree, took ketamine, lost consciousness and fell to her death (p. 112).

- What’s it like? In addition to hallucinations and giggling, the user also experiences floating sensations and numbness. It is difficult to walk straight and a strong enough dose may result in drooling and slurred speech. Mandy Saligari of Charter Harley Street, a rehab clinic, describes the K-hole state after a large dose as the relaxed state one experiences when lying comfortably in bed — with an added hallucinogenic edge (p. 112). Users might wander the streets in a daze. Max Daly warns that ketamine is ‘dissociative': one can stare at a bed without knowing what it is for (p. 114).

- Recent deaths? In 2014, ketamine was attributed to two deaths: that of a 15-year old Londoner and a 26-year old Glastonbury festival goer. In 2013, an 18-year old girl died after taking ketamine at a music festival in Winchester (p. 114).

- When do users start? Mandy Saligari, who tours schools giving talks about drugs, says that users are getting younger with an increasing number starting at age 14 or 15. She adds that they are ‘confident’ that they will suffer no negative side-effects (p. 112) However, many more young people begin taking the drug at university, including students who had no prior drug history (p. 114). No doubt ketamine is presented by their peers as being a harmless weekend drug.

One woman’s ketamine story

The Tatler feature ended with an anonymous first-person account (pp. 114-116) by a young woman who began using ketamine at university, where she lived with five friends of hers.

She had no previous drug history, although she did get into trouble at boarding school for drinking.

She was attracted to ketamine because it was cheap. A £20 gram sufficed for an evening out with friends.

Within a few months she began taking ketamine several times a week: a small quantity for a buzz or a larger one for a K-hole with its hallucinations. She described her K-hole experiences as ‘euphoric’ and, even though they lasted only a half hour, she said she discovered she ‘liked getting totally out of my mind’.

Later, she wanted more of an escape. Near the end of her first year at university, she mixed ketamine with valium, coke and MDMA. She passed out. Panicked, her friends rang her parents. She woke up three days later in a rehab clinic, where she stayed for a month.

Only 19 at the time — 2008 — and attending the clinic’s outpatient programme, she resumed drinking and taking ketamine in her flat with the curtains closed. She no longer saw the point in living. Her counsellor suggested going to South Africa to cure the addiction once and for all.

This woman spent three years in a South African rehab centre. She returned to London in 2011 to reconnect with friends and to find a job.

Now 26, she works for an estate agent. She still goes out with her friends but restricts herself to a drink or two. She knows of only one friend who hasn’t taken drugs: ‘Lucky her’.

Warnings to parents

Two people in the know warn parents about the effects that K-holes can have on users (p. 114).

Mandy Saligari of Charter Harley Street urges parents to talk to their children about the dangers of ketamine. She mentions the ‘heartbreaking’ YouTube videos of ketamine users ‘wandering around off their heads’.

Max Daly, author of Narcomania: How Britain Got Hooked on Drugs, says that parents should be ‘really worried’ if their children start taking ketamine, ‘much more so than if they’d taken cocaine’.

Bladder, stomach and muscular damage

The thing that really shocked me was reading that ketamine may cause irreversible bladder and stomach damage.

In fact, the article begins by talking about users in their 20s who are incontinent. British urologists are seeing more and more cases of ketamine users with serious — sometimes permanent — bladder disorders. Some of them are only teenagers (p. 111)!

Users with stomach damage are bent over, holding their gut because of the pain (p. 112). This is known as K-cramp.

Dan Wood, a urologist at University College London Hospitals, said that ketamine is toxic to the bladder lining: ‘it works like paint stripper’ (p. 112).

Urologists held a conference in 2013 — K-Day — to discuss the phenomenon. In some cases, they need to reconstruct a ketamine user’s bladder from bowel tissue — then attach a catheter (p. 112). This is no temporary measure. This is for life.

Other users with bladder problems might need to wear incontinence pants or pads (p. 111). Some might recover, provided they stop using ketamine. For others, however, it will be too late.

Another serious side-effect of extended ketamine use is muscular damage. The drug can stiffen and damage muscles over time. One parent was horrified that his son couldn’t stop ‘walking like a chicken’ (p. 112).

Tomorrow’s post will have more from ketamine users and urologists.

Ketamine is not to be taken lightly or dismissed simply as a horse tranquilliser which is safe for humans. The highs are short and their effect can last a lifetime.

 

In the same edition of The Observer which featured articles about drugs on the dark net and the UK’s head of the drugs disruption unit, was a gem by Anonymous.

Anonymous’s article is called ‘I like the way MDMA gives you a deep sense of connection to your friends’.

A better title would have been ‘Why I — and many others — take cocaine’.

Some of what he says is breathtaking and not in a good way (emphases mine):

I probably take class-A party drugs such as MDMA or cocaine once a fortnight, and have done since I was 16 (I’m 27 now). I like the way cocaine gives you a new lease of life, like a mushroom in Super Mario, to carry on with a night out. I like the way MDMA softens the edges of reality and gives you a deep sense of connection to your friends that you can never get when you meet them for dinner and they moan about their jobs. I like how when you’re coming down from a pill another person’s touch has a comforting, almost electric capacity. If you’re suffering from exhaustion, anxiety or stress, recreational drugs can give you a bit of a leg-up.

On the other hand:

Drugs can also be a total pain. Ecstasy can make you feel like you’re floating in a cloud, but just as often it’s an admin nightmare: you come up at different times from your friends; only half the people in a group remembered to get sorted and there’s endless hassle at a party trying to get more. Even when you’re having a great time, there’s a self-doubting internal monologue running through the whole process

There’s the key to the whole problem: self-doubt. Entirely normal for that age group, but why do so many young people evade the issue and instead get completely out of their box?

Anonymous doesn’t think the British public are honest and open enough about drugs. I suspect they are not, but Anonymous does go a bit too far in the opposite direction. And most of what he has to say hardly applies to everyone who’s ever fallen on the dark side of drugs.

He describes himself and his friends:

In my demographic – under 30, living in London, job in the creative industries, disposable income – almost everyone is a recreational drugs user.

Where I grew up in south London, it was pretty uncommon to find someone who didn’t at least smoke weed. The children of more middle-class parents were taking cocaine, ecstasy, ketamine and mephedrone almost every weekend. These were not reprobates ruining their lives: they were intelligent, bright people who got three As at A-level and went to good universities ...

In some families drug use had less stigma than smoking.

At university, he enjoyed mephedrone — a legal drug no longer available:

Mephedrone was incredibly cheap – about a tenner a gram – and incredibly available. You could order it with next-day delivery to your university PO box. Mephedrone was a drugs phenomenon of which I have never seen the likes before or since. Everyone started doing it

On nights out during this time, everyone would be raging – making out with one another, dancing with total abandon. But the comedowns were immediate and severe, far worse than ecstasy. By 4am people would be lying on the floor sharing the most intimate and personal shames and secrets, as if the drug was somehow compelling them to be honest. Some people called it a truth serum. Friendships were forged in the hot irons of that emotional exposition, as were the most horrendous hangovers.

Mephedrone was banned within two years of it taking off. People talk a lot about one legal high being banned only for another to take its place, but the real legacy of mephedrone was to numb the stigma of harder drugs. By the time I left university, many of the drug abstainers who had tried mephedrone became relaxed about most illegal drugs, too.

This is part of the issue I have with legalising drugs. We do not know what the full effects of many of these compounds, natural or synthetic, will be in the long run. Therefore, there is no justification in being ‘relaxed’ about it.

Even in the short term, he concedes they inhibit normal functioning for the next few days, which is why he takes cocaine:

Ecstasy and mephedrone make it pretty hard to get much done in the days after taking them. You can’t regularly use them and be a successful, functioning adult, so they become a rarer treat once you leave student life. In their 20s most people are overworked: they have second jobs and work incredibly long hours. If they’re going to go out on a Friday night they need a pick-me-up. And that is why cocaine remains the young professional’s drug of choice.

He says:

I also appreciate that’s it’s easy to be blasé about drug use when you’re a well-adjusted middle-class white guy who has never been stopped by the police and has a distant non-social relationship with their drug dealer. For many people, drugs aren’t something they can dip in and out of and separate from their lives. People entangled in the economic and legal realities of drugs – dealers, those convicted of possession, addicts – don’t have the luxury of my relaxed attitude.

Wow, just wow! The arrogance!

A reader, fictionfanatic, replied in the comments below with his own, opposite, experience:

I found this article excruciatingly painful to read. Not because the article is poorly written, in fact, I found the author to be incredibly articulate, but because I have twice overdosed on class A drugs and am now five years in recovery from active addiction

In the early years of my using I had some wonderful experiences on drugs. I agree with a great deal that this writer has to say and I particularly support his argument that drugs should no longer be the ‘taboo’ subject that it is today.

However, there is one sticking point for me. The reference the writer made to drugs giving him the confidence, the laughs and the energy that he doesn’t believe he already possesses.

As an addict I became painfully aware of what drugs had taken away from me when I got clean …

Various drugs do indeed boost confidence, increase energy levels and lighten the mood, however, if a person requires a chemical to do this then even the most casual user is denying themselves the opportunity to have fun, gain confidence and increase energy levels without the use of a drug. I learnt this when I fell threw the doors of a rehab and realised the overly confident, work hard/play hard exhibitionist had disappeared with the class A’s and I was left to rebuild the anxious, self-conscious, shattered shell of a human being that had relied for too many years on drugs to help me be somebody I was not.

Five years later I am now naturally confident and I laugh more than I ever did. I still go out all night sometimes, but I don’t have to pay for it with two days in bed or ‘suicide Tuesdays’.

drugs don’t add to our life experience, they merely mask what isn’t naturally there.

And, one final point… I have never, ever, ever met anyone that is better company when they are on coke. Not once!

I agree. I remember a few acquaintances from the 1980s who took coke. They just were not very nice to be around. They were abrupt, picked arguments and became aggressive. Everything was all about them. Cocaine is not a ‘nice’ drug.

Speaking of the 1980s, I remember reading a lengthy first-person magazine article at that time about a guy from New York who was absolutely broken through cocaine use.

At first, he had it all: great job, superb salary, stunning girlfriend and a beautiful flat. He and his girlfriend eventually started spending more and more on coke because their highs were no longer as long-lasting.

The ending was chilling. He and his girlfriend started having violent arguments. She left him and went into rehab. He stayed behind in the flat. He was having trouble making his mortgage payments. His boss was on the verge of firing him.

The last two days he spent in the flat involved his crawling around on hands and knees sniffing his carpet for any remaining coke dust that might be there. Finally, a friend of his stopped by. The addict fell into his friend’s arms crying like a baby.

By then, he had no job. He hadn’t a penny left. He’d lost the woman he loved.

He had allowed cocaine to destroy him and a beautiful life.

He came out the other side and wrote the article post-rehab. He said he would never be able to recapture what he once had. He was working a rather low-paid job in another industry. But, he said, at least he was clean after a few years of rehab and therapy. He wanted to stay that way but was worried about what the future would hold.

He hoped his story would serve as a warning against drug use, especially cocaine.

No good can come of drugs, particularly this one.

Regardless of whether one smokes tobacco, it is instructive to read of the effects smoking bans have on the leisure industry.

The Pub Curmudgeon has a tally of the numbers of pubs which have closed since July 1, 2007, the date England’s smoking ban came into effect. As I write, the number of defunct pubs now totals 14,192.

Now there are those who do not go to pubs, however, when one thinks how one piece of legislation could cripple such an inherent part of English life and culture, it beggars belief. Think of all the jobs lost through this draconian law.

To be sure, there are other factors, and the Pub Curmudgeon explores these — such as drink drive laws as well as large pub companies’ arrangements with their tenants — but, there is no question that the smoking ban is killing our pubs.

The Pub Curmudgeon says (emphases mine):

This is not a beer blog. It’s a view of life from the saloon bar, not entirely about the saloon bar – which of course is a metaphorical place as well as a physical one. It is as much about political correctness and the erosion of lifestyle freedom as it is about pubs and beer. And, while I enjoy cask beer, I don’t assume that it is the only alcoholic beverage worth consuming.

I’m a non-smoker, but not an antismoker. I believe the owners of private property should be entitled to choose whether or not smoking is permitted on their premises. If any supporter of pubs still thinks the smoking ban was a remotely good idea, just look around at all the pubs that have closed since 1 July 2007. The smoking ban is what prompted the creation of this blog back then and, while it touches on many other topics, it remains essentially its core theme. However, there remains much to be enjoyed and celebrated in pubs despite the effects of the ban.

I condemn drunken driving, but there is no evidence that driving after consuming a small quantity of alcohol is dangerous, and the campaign to discourage driving even within the British legal limit has been a major cause of the decline of the pub trade in recent years. Reducing the current legal limit – a proposal fortunately rejected by the Coalition government – would lead to the closure of thousands more pubs and would not necessarily save a single life. In my view, this is at least as much a threat to pubs as the smoking ban.

When Labour MPs discussed the smoking ban on news programmes, many cited how well local, then afterwards, statewide bans worked in California. Hmm. Not many Britons would compare our climate to California’s.

However, the California comparison seems to have been used in the US as well. Yet, whereas it’s relatively easy to spend time outdoors on a bar or restaurant terrace there for a smoke, the rest of the United States has a variable climate depending on where one lives. This makes the California comparison particularly disingenuous.

The Federal Reserve Bank of St Louis has a few articles on the impact of smoking bans by state or region, including their effect on casino revenue.

In 2009, the St Louis Fed noted that Illinois was the only state at that time which extended the smoking ban to casinos. ‘No Ifs, Ands or Butts: Illinois Casinos Lost Revenue after Smoking Banned’ states:

In the first year after the smoking ban took effect, revenue at Illinois casinos fell sharply from the previous year.4 As shown in the figure, the decline in revenue stands in sharp contrast both to the growth of recent years and to the performance of casinos in nearby states.

The Illinois Casino Gaming Association, they say, disputes that and says the economic downturn was responsible.

I’m not a huge casino fan, but I do have empathy for people who may have lost their jobs there during that time. Casinos have gift shops and restaurants, too. They also generate a lot of tax, some of which gets put back into schools and communities.

The Fed’s chart shows that Illinois — in contrast to Indiana, Iowa and Missouri — experienced a huge drop in revenue in 2008:

Using our estimates of revenue losses and declining attendance at each of the casinos in Illinois, we find that the tax loss was more than $200 million in 2008. For the local communities, the total loss in tax revenue amounted to over $12 million.

The economic effects of the Smoke-Free Illinois Act—specifically with regard to casino revenue and government tax receipts—represent only part of the act’s overall impact. In a full analysis, these costs need to be considered alongside other costs and benefits, including the public health benefits of the legislation. But as policymakers in Illinois and elsewhere ponder the implications of the Illinois smoking ban, the impact on revenue, attendance and taxes should not be ignored.

It’s quite easy for people who live downstate to go to St Louis. Those in the Chicago area can spend an hour or less travelling to Indiana. Iowa is a stone’s throw away for many in western Illinois.

However, back to the California comparison. Another St Louis Fed article from 2008, ‘Clearing the Haze? New Evidence of the Economic Impact of Smoking Bans’ tells us:

A previous article in The Regional Economist (“Peering Through the Haze,” July 2005) described some early evidence on the economic impact of smoke-free laws and suggested that the findings were far from conclusive.1

As more communities have adopted smoke-free laws and more data have been gathered, economists have discovered new, significant findings. As an earlier article suggested, economic costs often focus on specific business categories—those that smokers tend to frequent.

They cite research saying that bar employment has gone down between 4 and 16 per cent. Restaurants have experienced less of a decline, however, it depends on where they are located and whether the majority of their clientele are smokers.

However, the real issue is climate:

Restaurants in warm climates fared better than those in cooler climates. The authors suggest that the reason for this might be that restaurants in warmer climates can more easily provide outdoor seating where smoking is not prohibited … Restaurants that suffered the dual curse of being in regions with colder climates and a high prevalence of smokers suffered statistically significant employment losses, on average.

California, therefore, cannot be used as a template for everywhere else in the Northern Hemisphere.

The article features an item about the effects of the smoking ban on restaurants in Columbia, Missouri. It says, in part:

Since January 2007, all bars and restaurants in Columbia, Mo., have been required to be smoke-free. Only some sections of outdoor patios are exempt from the requirement.

Some local businesses have continued to oppose the Columbia Clean Air Ordinance, circulating petitions to repeal the law by ballot initiative. According to local press reports, owners of at least four establishments have cited the smoking ban as a factor in their decision to close their doors in 2007.

Recent data from the city of Columbia show a distinct decline in sales tax receipts at bars and restaurants. After rising at an average rate of 6.8 percent from 2002 through 2006, tax revenue declined at an annual rate of 1.3 percent over the first seven months of 2007. (See graph.) Although the data are still preliminary, initial analysis suggests a 5 percent decline in overall sales revenue at Columbia dining establishments since the implementation of the smoking ban. This estimate takes into account past trends, seasonal fluctuations in the data and an overall slowdown in sales tax revenue in Columbia. 6

Of course, as is true everywhere else, the answer is outdoor patio space:

One owner was quoted as saying, “You have to have a patio to survive.”7 The expenses associated with these renovations may help buffer the sales revenue of these establishments, but they also represent profit losses that are above and beyond the measured sales declines.

Two things are certainly true of smoking bans: they harm business and create unemployment.

Smoking bans appear to be all about health.

However, when we allow state, local or federal government to dictate to private businesses and property owners what we can and cannot do in these premises, we are on a slippery slope that will affect more of us than just the smoking population.

Sean Turner, writing for New Visions Commentary — the National Leadership Network of Conservative African Americans — says we should be concerned about this downward trajectory.

In ‘Property Rights Going Up In Smoke’, he explains (emphases mine):

The attempt by federal, state and local governments and with various anti-smoking organizations to modify our behavior is bad enough.  I believe there is a greater issue relating to smoking bans, however, with which we must concern ourselves.  This concern is the threat to property rights.

A property right is the exclusive authority to determine how a resource is used – whether it’s a car, house, business or any other resource of which one is the owner.  Additionally, private property rights confer an exclusive right to the services of the resource – as well as the right to delegate, sell or rent any portion of the rights by exchange or gift based on mutually agreeable terms.  Conversely, public property is property controlled by the state (government) or a community.

While most would agree with these definitions, many seem to suffer a severe logical disconnect when leaving their homes (i.e., private property) and enter into a restaurant, retail store or other places of business that they do not own (i.e., someone else’s private property). 

Though a business exists to provide a product or service to potential consumers, it should be allowed to do so under the terms of those who own it and not those of the state, or some third party using the state as a tool of coercion.  These terms include the environment in which those products or services are offered.  If the terms are agreeable to both the business owner and potential consumer, a transaction occurs and both parties walk away having benefited.

Just as one lacks the unfettered right to enter into another’s home – much less restrict smoking in it – one also lacks the right to enter into another’s business.  One is given access to the business by the owner who hopes to conduct a transaction, not cede control of the business.

Contrary to popular belief, one does not have the unfettered right to dictate the usage [of] another’s property – whether it be a house or place of business – particularly when one has the ability and choice to avoid that place, and its real or perceived ill-effects.

Few argue the ill-effects of smoking tobacco, as the CDC other organizations continuously point them out.  As someone who believes in the principles of liberty, I find it deplorable when anti-smoking policies are applied to private property and violate the U.S. Constitution.  Not only does this violate the fundamental principal of property rights, but it is also anathema to the concept of a free society.

In the UK, the smoking ban prohibits smoking tobacco in a company vehicle. That is not a decision individual companies make; it is the law. In time, this may be extended to people in their own vehicles where children are passengers.

Wouldn’t it have been better to let companies, pubs, clubs and other privately-owned establishments to decide whether to allow tobacco smoking in or on their property, be it grounds, vehicles or a building?

Incidentally, the Palace of Westminster still has a bar where smoking is allowed. Our politicians are exempt from a law they passed for the rest of us, the people whom they are supposed to serve.

Both the US and the UK have proposed limits on our rights to free speech this year.

I’ll look at the US tomorrow. Today’s post concerns the decay in the UK.

Just a few days ago in Birmingham, Conservative Home Secretary Theresa May spoke of government proposals to limit freedom of speech in order to help to stem Islamic extremism.

The BBC’s home affairs correspondent Dominic Casciani analysed the policy proposals. They might end up being aimed at the average Briton. Excerpts follow, emphases mine:

There are three prongs to her planned changes to how the government tackles extremism:

- New powers to ban extremist groups

- New powers to curtail the activities of individual extremists

- Bringing the entire strategy under her control

The first two are General Election manifesto pledges so their future is down to you and the ballot box.

The decision to bring extremism strategy into the Home Office is already policy – and it is about more than rearranging the machinery of government: It’s a symbol of the tensions inside Whitehall over whether every previous attempt to combat extremism has been a muddled flop.

However, that was true under Labour as well. Hardly any extremists we read about in the newspapers have been prosecuted under hate or extremist speech laws. Furthermore, several have been average citizens who had a public outburst.

According to Casciani, May’s new proposals would seek to ban groups or persons who intend actual violence or incitement to same. They sound similar to what Labour legislated during their tenure in office. The only difference appears to be that May would transfer these powers from the Labour-created Department of Communities to the Home Office.

However, implementation of these new laws — do we actually need more? — could have a more general impact on the overall population’s freedom to express an opinion:

These counter-extremism banning orders go further. They would allow ministers to outlaw a group if it:

- Spreads, incites or promotes hatred against a person or group

- Seeks to overthrow democracy

- Causes some kind of public harm, such as leaving people in fear and distress.

If such banning orders came in, they could lead to a considerable curtailment of public or online comment and campaigning.

Labour’s anti-hate laws have, in reality, revolved heavily around the third point above: it’s hate if someone else — a bystander or witness — says it is.

Yet, hateful speech by certain persons has featured in our news stories for well over a decade — time and time again. Nothing ever happens.

Casciani cites one example:

Last week the controversial Islamist preacher and political activist Anjem Choudary, and his associates, were arrested as part of an investigation into their activities. Almost all of the men were later bailed – but police have banned them from talking to each other or proselytising on the streets.

It’s not stopped the men speaking to the media or online – within hours of his release, Mr Choudary met me on a London street to denounce Parliament’s decision to join military action in Iraq.

Which brings us to the most controversial question about this package: Does it undermine the very values the government is setting out to defend?

Labour put enough laws in place for this type of thing. It would be better for the Conservatives to work within that restrictive framework:

The former Attorney General Dominic Grieve QC says that he is concerned that extremism powers could result in people being prosecuted for having a point of view. He warns that could fuel resentment and the Home Secretary would have to convince MPs why extremists could not be prosecuted under existing hate crime laws.

Grieve is not wrong in his assessment. Let us hope this was merely a Conservative Party conference ‘idea’ that will not see the light of day.

It seems superflous. However, these days, it is difficult to determine what is ‘new’ and bold with regard to what is mildewed and old.

A comment recently appeared on a PoliticalBetting.com post which indicates that the average Englishman in 1914 had more freedoms — and less government interference — than in 2014.

Below, PB.com contributor Richard_Tyndall quotes historian AJP Taylor, who said (emphases mine):

Until August 1914 a sensible, law-abiding Englishman could pass through life and hardly notice the existence of the state, beyond the post office and the policeman. He could live where he liked and as he liked. He had no official number or identity card. He could travel abroad or leave his country for ever without a passport or any sort of official permission. He could exchange his money for any other currency without restriction or limit. He could buy goods from any country in the world on the same terms as he bought goods at home. For that matter, a foreigner could spend his life in this country without permit and without informing the police. Unlike the countries of the European continent, the state did not require its citizens to perform military service. An Englishman could enlist, if he chose, in the regular army, the navy, or the territorials. He could also ignore, if he chose, the demands of national defence. Substantial householders were occasionally called on for jury service. Otherwise, only those helped the state who wished to do so. The Englishman paid taxes on a modest scale: nearly £200 million in 1913-14, or rather less than 8 per cent. of the national income. The state intervened to prevent the citizen from eating adulterated food or contracting certain infectious diseases. It imposed safety rules in factories, and prevented women, and adult males in some industries, from working excessive hours. The state saw to it that children received education up to the age of 13. Since 1 January 1909, it provided a meagre pension for the needy over the age of 70. Since 1911, it helped to insure certain classes of workers against sickness and unemployment. This tendency towards more state action was increasing. Expenditure on the social services had roughly doubled since the Liberals took office in 1905. Still, broadly speaking, the state acted only to help those who could not help themselves. It left the adult citizen alone.

Fair enough, some of these — National Service in the military — haven’t existed for decades.

Yet, others are still current: the need for a passport, ever-increasing taxes (the average is upwards of 60 per cent per annum) and, at least in the 1990s, the requirement for foreigners here on work permits to register with the police once a year.

The freedom of movement back then was impressive. Unfortunately, we could not go back to that, given our current immigration levels from around the world.

Passports became mandatory during the Great War (World War I) for reasons of security and immigration control.

In the United States, income tax was enshrined in the Constitution in 1913. As early as 1918, the annual internal revenue collection surpassed $1bn. By 1920, this amount had increased to $5.4bn.

This month’s posts will largely concern increasing statism, health care control, church participation and the attendant peer pressure upon all three.

Some posts you might agree with, others might merely give pause for thought. In short, can we be certain that all we are told by governments and ‘experts’ is true?

And what about the personal conduct of the personalities behind morals and good causes? I explored two recent scandals yesterday.

Why October? Because this is the third year of the NHS’s Stoptober anti-smoking campaign. Yes, Britain has had a comprehensive smoking ban since 2007, which includes nearly all hotel rooms, sometimes entire hotel or B&B premises. It also mandates smoke-free company vehicles. Smoking cessation helplines have been in existence long before that and still continue.

We are all aware of them. Isn’t that enough, small ‘l’ libertarians ask?

No, anti-smoking campaigners say. There must be more, much more: plain packaging, restrictions on smoking in the car and so on.

Anti-alcohol campaigns running throughout the year use the same lines which once were ‘uniquely’ applicable to tobacco. Britain’s non-smokers who enjoy a glass of wine with dinner could well find that minimum pricing will make that gustatory and digestive pleasure cost that much more.

To counter this anti-smoking industry which is here to stay, a number of British bloggers participate in #Octabber as a contrarian voice for personal liberty for adult smokers. None of them is promoting smoking and not all are smokers. They are, however, asking governments to leave smokers alone. Seventy-five per cent of the price of a pack of cigarettes (19 or 20) goes to the British government. Should that not suffice?

#Octabber campaigner Pat Nurse explains in her 2014 post on the subject (emphases mine):

Here we are again. Now in it’s third year, Stoptober, Nanny’s do as we say October campaign is back again in a bid to force us all into the perfect size 10, non drinking, non smoking, tofu-eating, water-supping perfect human specimens to, presumably, ensure we can become 150 year old burdens on society. However, this year on Twitter, it seems to be targeting all sorts of undesirables from smokers, to drinkers to the overweight – and jumping on the bandwagon a month in advance is the long-running Movember and new Govember campaigns, for those who like to grow moustaches and goatee beards …

However, #Octabber is about much more than just a statement from informed adult consumers who want to be left alone in peace without harassment to enjoy a legal product of choice. We resent the waste of tax payers cash on such silly gimmicks which do not have the effect the professional healthists brag about. Thousands/millions (insert outrageous stat for effect) of smokers do not quit during the month and you only have to check out the #Stoptober hash tag to see that it’s mostly health professionals, local authorities, alleged charities, and other tax funded, Big Pharma and corporate funded organisations that are getting excited about it. After all, their jobs depend on coming up with such propaganda and they are as dependant upon smokers for their living as the tobacco companies.

Despite the ever increasing hate campaign, marginalisation and stigmatisation of smokers, calls to ban them from outdoor public places, that they have every right to use, moves to remove yet more private property rights with car bans and home bans on the horizon, it seems we are still increasing in numbers with new figures that show one in five people still smoke

We are and remain totally against any bullying, coercion, community campaign, ban, junk science “study”, or untrue propaganda , such as smokers cost everyone else more money. – we don’t – which is aimed at making us quit through forced marginalisaton.

My problem with all these campaigns is that none of us really knows enough about the people behind the organisations promoting them. Certainly, we know names and see the leading personalities from ASH, to name one, on television, however, it would be helpful to know more about their worldview, their career progression and what the end game of anti-smoking and anti-alcohol movements actually is.

Churchgoers who think such public health campaigns are a better organised renaissance of temperance and clean living might be disappointed to find that, in time, they could progress to a push for legalisation of illicit, dangerous drugs.

Professor David Nutt is one such campaigner who is at least open about his intentions. He was an advisor in the preceding Labour government to the Ministry of Defence, Department of Health and the Home Office until his editorial ‘Equasy’ which appeared in the Journal of Psychopharmacology:

In February 2009 he was criticised by Home Secretary Jacqui Smith for stating in the paper that the drug ecstasy was statistically no more dangerous than an addiction to horse-riding.[22] Speaking to the Daily Telegraph, Nutt said that the point was “to get people to understand that drug harm can be equal to harms in other parts of life”. Jacqui Smith claimed to be “surprised and profoundly disappointed” by the remarks, and added: “I’m sure most people would simply not accept the link that he makes up in his article between horse riding and illegal drug taking”. She also insisted that he apologise for his comments, and asked him to apologise also to ‘the families of the victims of ecstasy’.[23]

That same year:

Prof Nutt was sacked by the then health secretary, Alan Johnson, from his post as chair of the government’s Advisory Council on the Misuse of Drugs for publicly stating that alcohol and tobacco were more harmful than LSD, ecstasy and cannabis. Despite his dismissal, his forthright views on drugs have rarely been out of the headlines and he has continued to campaign for a more rational government policy on drugs that takes into account the actual harms caused by them.

His website makes his position on illicit drugs quite clear.

More adolescents are indulging in recreational drugs at the weekend. I’ll have more on them later this month.

For now, let us contemplate a world where mind-altering drugs could gradually take over our society as the norm, rather than tobacco and alcohol.

At the weekend, two minor scandals broke in England.

One concerns Conservative MP Brooks Newmark who sent an indecent photo of himself to an undercover (male) reporter posing as a young Tory (Conservative) PR woman.

The most ironic aspect of this story is that Newmark was serving as Minister for Civil Society at the time. He resigned this post when the scandal came to light.

Readers might be interested to know that the Minister for Civil Society oversees charities, volunteering and the odious Big Society campaign.

There is also irony in the fact that he was also active in movements to promote women in Parliament: Women2Win and Girls Matter. Both stories from the Mirror make for unpleasant reading and are adult-only material.

This is total hypocrisy. This man was responsible for promoting communitarianism — a do-gooder concept if there ever was one.

The Conservative Big Society is modelled on the American policy laid out in the left-of-centre book Nudge. There are constant nudges to get the English to do this, do that and so on for a better society.

Yet, the minister in charge engaged in behaviour which put him out of a Cabinet position and, no doubt, jeopardised his home life.

Why should any of us listen to someone like that?

The second scandal concerns Catholic bishop Kieran Conry who has had to resign because he was having an affair with a married woman. This took place six years ago.

A second, more recent affair came to light which triggered the resignation. Ironically, Conry got to know this woman and her now-estranged husband through church programmes.

Yet, during his tenure he insisted on the Church’s ‘moral authority’ (his words) and the sanctity of family life.

He also rebelled against Pope Benedict XVI in criticising Latin Masses, which the former Pope had hoped to encourage.

A question now looms over what other Catholic clerics are up to in England and Wales; the answer remains to be seen.

These two scandals illustrate why I am highly suspicious of the current trend for social movements and religious self-righteouness. Hypocrites front them all too often.

pencilsIn reading the news blogs this morning, I ran across a comment about an Englishman who stands behind the belief that providing good education is more important than welfare in combatting poverty.

No link was provided to the man’s story, however, in short, his father’s business went bankrupt and the mother — a dentist — kept the household afloat whilst Dad was sorting out his debts.

He said that this concentrated the mind beautifully. He and his siblings linked his mother’s ability to support the family thanks to her education which qualified her for a profession. As a result, they took their school lessons seriously so that they would be able to support themselves as adults. The man is now an electrical engineer.

I do not know if this man might have spoken briefly at this week’s Conservative Party conference in Birmingham, however, what he says goes against the Labour Party philosophy that puts generous welfare ahead of education. Labour maintain that only when we resolve the issue of poverty will children become better educated.

I suspect the answer is a mix of the two. However, what is striking about the above story is how the children decided amongst themselves that education was the answer to their family’s financial problems. They studied more — and succeeded.

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